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South Dakota rates for HCPCS 50075

Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)

Facilitymedian $1,905 · 10th–90th $1,380–$4,3650%20%10th90th$1,905Professionalmedian $1,862 · 10th–90th $1,380–$3,8900%20%10th90th$1,862$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,479.11 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,311.31 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,089.30 / $3,715.35
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,630.27 / $10,715.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,162.28 / $3,388.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,454.71 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,884.03 / $4,073.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,311.31 / $3,388.44